Betamethasone in prevention of postoperative nausea and vomiting following breast surgery

Olanders, Knut; Lundgren, Gerd A. E.; Johansson, Anders

doi:10.1016/j.jclinane.2014.02.006

Cited by 23 publications

(12 citation statements)

References 19 publications

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“…Specific treatments have been designed to reduce nausea and vomiting, reduce acute pain levels, and improve the quality of recovery after surgical procedures. Administration of dexamethasone [ 24 ] or betamethasone [ 25 ] prior to surgery has been shown to be beneficial by preventing PONV after various surgical procedures. Dexamethasone with higher dose has also been shown to reduce the postsurgical pain intensity and analgesic requirement immediately after a mastectomy [ 26 ].…”

Section: Quality Of Recovery After the Surgerymentioning

confidence: 99%

Can Acute Pain Treatment Reduce Postsurgical Comorbidity after Breast Cancer Surgery? A Literature Review

Amaya

Hosokawa

Okamoto

et al. 2015

BioMed Research International

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Regional analgesia, opioids, and several oral analgesics are commonly used for the treatment of acute pain after breast cancer surgery. While all of these treatments can suppress the acute postsurgical pain, there is growing evidence that suggests that the postsurgical comorbidity will differ in accordance with the type of analgesic used during the surgery. Our current study reviewed the effect of analgesics used for acute pain treatments on the major comorbidities that occur after breast cancer surgery. A considerable number of clinical studies have been performed to investigate the relationship between the acute analgesic regimen and common comorbidities, including inadequate quality of recovery after the surgery, persistent postsurgical pain, and cancer recurrence. Previous studies have shown that the choice of the analgesic modality does affect the postsurgical comorbidity. In general, the use of regional analgesics has a beneficial effect on the occurrence of comorbidity. In order to determine the best analgesic choice after breast cancer surgery, prospective studies that are based on a clear definition of the comorbidity state will need to be undertaken in the future.

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Section: Quality Of Recovery After the Surgerymentioning

confidence: 99%

Can Acute Pain Treatment Reduce Postsurgical Comorbidity after Breast Cancer Surgery? A Literature Review

Amaya

Hosokawa

Okamoto

et al. 2015

BioMed Research International

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“…In a recent study, Olanders, Lundgren and Johansson (2014) assessed the effects of 8 mg of betamethasone on the incidence of post operative complications in 75 patients undergoing conservative breast surgery (CBS) with and without axillar lymph node dissection. They found a significant 11% reduction in the cumulative incidence of PONV and a 40% reduction in the incidence of post operative pain compared with a control group.…”

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confidence: 99%

Effects of preoperative dexamethasone on postoperative pain, nausea, vomiting and respiratory function in women undergoing conservative breast surgery for cancer: Results of a controlled clinical trial

et al. 2017

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The objective was to evaluate whether pre operative administration of dexamethasone improved post operative nausea and vomiting (PONV), pain and respiratory function tests in women undergoing conservative surgery for breast cancer. This was a controlled clinical trial conducted between June 2013 and October 2014. Eighty patients were evaluated. Patients received a pre operative dose of 8 mg of dexamethasone (n = 40) or placebo (n = 40). The data on PONV and pain intensity was obtained and forced spirometry tests were performed, 1 hr before and at 1, 6, 12 and 24 hr after surgery. Any use of additional analgesic/antiemetic drugs was recorded. Patients were followed until 30 days after surgery for any surgical or medical complications. The pain intensity was lower in the treatment group for all periods; PONV was lower at 6, 12 and 24 hr; Additional analgesics/antiemetics were required less frequently (all p < .05).Both groups exhibited a restrictive ventilatory pattern immediately after surgery, which was reversed in the following hours. However, spirometric values were higher in the dexamethasone group. There were no pulmonary or metabolic complications after surgery. Our conclusions were that dexamethasone significantly reduced the incidences of PONV, pain and improved respiratory parameters, and reduced the need for additional post operative analgesic and antiemetic drugs. K E Y W O R D Sdexamethasone, mastectomy, nausea, postoperative pain, respiratory function tests, vomiting | INTRODUCTIONGlobally, breast cancer (BC) remains the most common malignancy in women. In developing countries, such as Mexico there has been an increase in mortality caused by BC (Rodríguez-Cuevas, GuisaHohenstein & Labastida-Almendaro, 2009;Siegel, Ma, Zou & Jemal, 2014). It is the most common cancer in this country, followed by cervical intraepithelial neoplasia; each year 25,000-30,000 new cases are diagnosed. Fortunately, more patients now have access to proper screening using mammography, so the proportion of patients with local tumours found at diagnosis is increasing. Total or partial mastectomy with or without axillary lymph node dissection is the most frequently used surgical treatment, along with adjuvant chemoor radiotherapy. Post operative nausea and vomiting (PONV) is a common complication after anaesthesia and surgery (Kovac, 2000;Watcha & White, 1992). Women undergoing mastectomy are at particularly high risk for developing PONV, and the reported incidence is 60%-80% in patients not receiving antiemetic medication (Hammas, Thorn & Wattwil, 2002;Oddby-Muhrbeck, Jakobsson, Andersson & Askergren, 1994;Sadhasivam et al., 1999). Emetic episodes predispose patients to numerous complications, such as gastric aspiration, wound dehiscence, psychological distress, and delayed recovery and discharge times (Watcha & White, 1992). These reasons justify the use of prophylactic antiemetics in women scheduled for breast surgery. In addition, respiratory function is often compromised after a major surgical procedure, particularly those p...

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“…The recent article by Olanders et al [1] assessing efficacy of betamethasone on postoperative nausea and vomiting (PONV) and pain in patients undergoing elective breast surgery was of great interest to us. They conclude that preoperative betamethasone reduces the severity of PONV and pain.…”

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confidence: 99%

“…Effects of setting a heat moisture exchanger filter in a vertical position on water accumulation in low-flow anesthesia ☆,☆☆ To the Editor, In low-flow anesthesia, the water generated by a chemical reaction of the CO 2 absorbent is distributed as condensed water in the CO 2 absorbent, inhalation check valve, inspiratory limb, and heat moisture exchanger filter (HMEF) [1]. This condensate can cause reduced CO 2 absorption capacity [1], valve failure, gas monitor failure, increased risk of crossinfection, and increased airflow resistance at the HMEF [2][3][4].…”

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Efficacy of betamethasone to prevent postoperative nausea and vomiting or pain

Liu

Xue

et al. 2015

Journal of Clinical Anesthesia

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Betamethasone in prevention of postoperative nausea and vomiting following breast surgery

Abstract: Measurements: The rate of PONV and pain using a numeric 0-10 rating scale (NRS), as well as rescue doses of antiemetics (ondansetron) and analgesics (ketobemidone). Main results:

Cited by 23 publications

References 19 publications

Can Acute Pain Treatment Reduce Postsurgical Comorbidity after Breast Cancer Surgery? A Literature Review

Can Acute Pain Treatment Reduce Postsurgical Comorbidity after Breast Cancer Surgery? A Literature Review

Effects of preoperative dexamethasone on postoperative pain, nausea, vomiting and respiratory function in women undergoing conservative breast surgery for cancer: Results of a controlled clinical trial

Efficacy of betamethasone to prevent postoperative nausea and vomiting or pain

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